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ALCOHOLISM 
CURRENT PROBLEM STATUS 
AND 
NEED FOR HOLISTIC 
APPROACH 
Dr. Prasanna P. Khatawkar 
Consultant Psychiatrist 
...
ALCOHOLISM 
CCUURRRREENNTT PPRROOBBLLEEMM 
SSTTAATTUUSS 
www.mhgi.in
wwwwww..mmhhggii..iinn
INDIAN PERSPECTIVE 
 ‘INTOXIFICATION’ PATTERN MORE PREVALENT 
IN INDIA 
 > 62.5 MILLION ALCOHOL USERS IN INDIA 
 6 – 8%...
 The mean age of initiation of alcohol : 
23 years in 1950 to 1960, 
19 years in 1980 to 1990 
17 years in 2006 
 Lifeti...
GENERAL OUTCOME – IF 
UNTREATED 
Trauma, violence, organ system damage, 
cancers, unsafe sexual practices, premature 
deat...
 15 to 20% of traumatic brain injuries were 
related to alcohol use. 
 37% of injuries in a public hospital were 
relate...
 20 % of psychiatric emergencies were 
caused by alcohol 
 34 % of those who attempted suicide were 
abusing alcohol 
 ...
 85 % of men who were violent towards their 
wives were frequent or daily users of alcohol. 
 > 50% of the abusive incid...
 3 to 45 % of household expenditure is 
spent on alcohol. 
 Use of alcohol increases 
indebtedness and reduces the abili...
ALCOHOLISM 
NEED FOR HOLISTIC 
APPROACH 
www.mhgi.in
WHAT DO YOU MEAN 
BY HOLISTIC ? 
www.mhgi.in
HOLISTIC 
 HOLISTIC HEALTH IS A CONCEPT IN 
MEDICAL PRACTICE UPHOLDING THAT 
ALL ASPECTS OF PEOPLE’S NEEDS, 
PSYCHOLOGICA...
WHAT INCLUDES HOLISTIC 
APPROACH ? 
 DISEASE MODEL OF ALCOHOLISM 
 MEDICAL TREATMENT 
 PSYCHOSOCIAL INTERVENTIONS 
 RE...
ROLE OF MEDICAL SPECIALIST 
 MANAGEMENT OF MEDICAL PROBLEMS 
 MANAGEMENT OF WITHDRAWAL STATE 
 MOTIVATE PATIENT AND HIS...
ROLE OF PSYCHIATRIST 
 DETOXIFICATION 
 IDENTIFY CO-MORBID PSYCHIATRIC 
ILLNESSES 
 CUSTOMISED PLAN FOR EACH PATIENT 
...
THE SUPPORTING TEAM 
 PSYCHIATRIC SOCIAL WORKER 
 NURSING STAFF 
 NGO’s 
 SELF HELP GROUPS 
www.mhgi.in
ROLE OF RELIGION 
 VERY IMPORTANT ROLE 
 CHRISTIANS – SOCIAL DRINKING 
 COMPARATIVELY LESS PROBLEM DRINKING 
 MUSLIMS ...
MAGICAL REMEDIES AND FAITH-HEALERS 
 ACCEPT OR DON’T ACCEPT 
THEY DEFINITELY PLAY A ROLE ! 
 EDUCATING THE SOCIETY IS TH...
HOW LONG SHOULD BE THE 
PROGRAM 
 FOLLOWING ALL STAGES ESSENTIAL 
 DETOXIFICATION - 2 TO 7 DAYS 
 DEADDICTION - MINIMUM...
ONCE 
AN ALCOHOLIC 
ALWAYS 
AN ALCOHOLIC 
www.mhgi.in
APPPROACH TOWARDS RELAPSES 
 ALCOHOLISM IS A DISEASE 
 IT IS GOING TO HAVE ITS OWN COURSE 
 RELAPSES ARE PART OF NATURA...
TTHHEE FFIINNAALL 
AAIIMM IISS …….... 
www.mhgi.in
www.mhgi.in
TThhaannkk yyoouu 
www.mhgi.in
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Alcoholism

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Alcoholism

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Alcoholism

  1. 1. ALCOHOLISM CURRENT PROBLEM STATUS AND NEED FOR HOLISTIC APPROACH Dr. Prasanna P. Khatawkar Consultant Psychiatrist Aadhar Hospital Specialty centre for Psychiatry and De-addiction Solapur www.mhgi.in
  2. 2. ALCOHOLISM CCUURRRREENNTT PPRROOBBLLEEMM SSTTAATTUUSS www.mhgi.in
  3. 3. wwwwww..mmhhggii..iinn
  4. 4. INDIAN PERSPECTIVE  ‘INTOXIFICATION’ PATTERN MORE PREVALENT IN INDIA  > 62.5 MILLION ALCOHOL USERS IN INDIA  6 – 8% RISE IN ALCOHOL SALES PER YEAR  80% DRINKING IN FORM OF HARD LIQUOR  40% BRANDED ALCOHOL  REST COUNTRY LIQUOR www.mhgi.in
  5. 5.  The mean age of initiation of alcohol : 23 years in 1950 to 1960, 19 years in 1980 to 1990 17 years in 2006  Lifetime abstainers (89.6%).  The female population 98.4% as lifetime abstainers.  Taxes generated from alcohol production and sale : approximately Rs.35,000 crores (2000) www.mhgi.in
  6. 6. GENERAL OUTCOME – IF UNTREATED Trauma, violence, organ system damage, cancers, unsafe sexual practices, premature death and poor nutritional status of families with heavy drinking fathers are associated with alcohol use. www.mhgi.in
  7. 7.  15 to 20% of traumatic brain injuries were related to alcohol use.  37% of injuries in a public hospital were related to alcohol. www.mhgi.in
  8. 8.  20 % of psychiatric emergencies were caused by alcohol  34 % of those who attempted suicide were abusing alcohol  20 % of absenteeism and 40% of accidents at work place are related to alcohol. www.mhgi.in
  9. 9.  85 % of men who were violent towards their wives were frequent or daily users of alcohol.  > 50% of the abusive incidents were under the influence of alcohol.  Domestic violence reduced to 1/10th of previous levels after alcoholism treatment www.mhgi.in
  10. 10.  3 to 45 % of household expenditure is spent on alcohol.  Use of alcohol increases indebtedness and reduces the ability to pay for food and education of children  Alcohol abuse leads to separations and divorces and causes emotional hardship to the family. www.mhgi.in
  11. 11. ALCOHOLISM NEED FOR HOLISTIC APPROACH www.mhgi.in
  12. 12. WHAT DO YOU MEAN BY HOLISTIC ? www.mhgi.in
  13. 13. HOLISTIC  HOLISTIC HEALTH IS A CONCEPT IN MEDICAL PRACTICE UPHOLDING THAT ALL ASPECTS OF PEOPLE’S NEEDS, PSYCHOLOGICAL, PHYSICAL AND SOCIAL SHOULD BE TAKEN INTO ACCOUNT AND SEEN AS A WHOLE www.mhgi.in
  14. 14. WHAT INCLUDES HOLISTIC APPROACH ?  DISEASE MODEL OF ALCOHOLISM  MEDICAL TREATMENT  PSYCHOSOCIAL INTERVENTIONS  RELAPSE PREVENTION STRATEGIES  MOTIVATION ENHANCEMENT  INVOLVING THE FAMILY  IDENTIFICATION AND TREATMENT OF CO-MORBID PSYCHIATRIC DISORDERS  CHANGING THE SOCIAL NORMS  CHANGE IN GOVERNMENT POLICIES www.mhgi.in
  15. 15. ROLE OF MEDICAL SPECIALIST  MANAGEMENT OF MEDICAL PROBLEMS  MANAGEMENT OF WITHDRAWAL STATE  MOTIVATE PATIENT AND HIS FAMILY TO UNDERGO COMPLETE DEADDICTION PROGRAM www.mhgi.in
  16. 16. ROLE OF PSYCHIATRIST  DETOXIFICATION  IDENTIFY CO-MORBID PSYCHIATRIC ILLNESSES  CUSTOMISED PLAN FOR EACH PATIENT  PRIMARILY RESPONSIBLE FOR THE DEADDICTION PROGRAM www.mhgi.in
  17. 17. THE SUPPORTING TEAM  PSYCHIATRIC SOCIAL WORKER  NURSING STAFF  NGO’s  SELF HELP GROUPS www.mhgi.in
  18. 18. ROLE OF RELIGION  VERY IMPORTANT ROLE  CHRISTIANS – SOCIAL DRINKING  COMPARATIVELY LESS PROBLEM DRINKING  MUSLIMS – LESSER PERCENTAGE OF PROBLEM DRINKERS www.mhgi.in
  19. 19. MAGICAL REMEDIES AND FAITH-HEALERS  ACCEPT OR DON’T ACCEPT THEY DEFINITELY PLAY A ROLE !  EDUCATING THE SOCIETY IS THE ONLY WAY OUT  GOVERNMENT HAS TO PLAY AN IMPORTANT ROLE TO PREVENT THIS MENACE ` www.mhgi.in
  20. 20. HOW LONG SHOULD BE THE PROGRAM  FOLLOWING ALL STAGES ESSENTIAL  DETOXIFICATION - 2 TO 7 DAYS  DEADDICTION - MINIMUM 7 DAYS - IDEAL ONE MONTH  CHARTED FOLLOW-UP PROGRAM - IDEAL ONE YEAR www.mhgi.in
  21. 21. ONCE AN ALCOHOLIC ALWAYS AN ALCOHOLIC www.mhgi.in
  22. 22. APPPROACH TOWARDS RELAPSES  ALCOHOLISM IS A DISEASE  IT IS GOING TO HAVE ITS OWN COURSE  RELAPSES ARE PART OF NATURAL COURSE IN A DISEASE CALLED ALCOHOLISM !!  ACCEPT THEM – IT WILL MAKE EVERYBODY COMFORTABLE !! www.mhgi.in
  23. 23. TTHHEE FFIINNAALL AAIIMM IISS …….... www.mhgi.in
  24. 24. www.mhgi.in
  25. 25. TThhaannkk yyoouu www.mhgi.in

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